Orthotown October 2013 - (Page 14)

orthotown.com // message board Townies share what kind of expanders they most often use. » Orthotown.com > Message Boards > Clinical Topics > Clinical Orthodontics > Phase I Expansion/Retention donticsortho Member Since: 06/25/12 Post: 1 of 48 t Phase I Expansion/Retention I had a couple of questions about what kinds of expanders you guys normally use. In residency I did one bonded expander and the rest were banded hyrax expanders. I never did a quad helix. I did one nitanium expander and I did not like the lack of control I had in the amount of expansion (it seemed like I blew the arches). In practice I mostly do bonded expanders and occasionally banded expanders for cases that will roll into Phase II. I like bonded expanders because you do not have to separate and cementation is pretty straightforward. The negatives are, of course, the oral hygiene and possible leakage (a big negative). I like banded expanders because they are more hygienic but there are a couple of more steps for fabrication (sep, fit bands, sep, cement). Can’t say much about quad helix since I’ve never used it. But for those of you who do use the quad, how do you like to activate? I remember an instructor telling me that you never know how much you really are activating it each time so you should really take it out of the mouth and re-cement it. After expanding them with either a bonded or banded I have them in a passive phase with the expander for six months and then have them wear the expander at night time until Phase II (sometimes this is pretty long). Do any of you place a TPA with arms so compliance doesn’t become an issue? The only problem I have with a cemented appliance is if they disappear then we may run into problems with OH and impingement. Thanks for your input! n AUG 11 2013 fesdds Member Since: 05/22/08 Post: 2 of 48 Bonded expanders are disgusting in most mouths and I will never use one of those in my practice. I think they are not a practice builder. I use a banded hyrax to the U6s only with a compact design screw. Yes, you have to separate, but it is quick. There are the big time criers every now and again, but most do fine and I would rather deal with a few minutes of crying over the OH complaints later on. I went through a phase of practice where I did nearly 100 percent quad and little RPEs. I think there is a place for using quads, but that an RPE is still the best for most patients needing true expansion. After enough practice you can get good at activating a quad in the mouth, but it can be tricky getting exactly the amount you are looking for the first time. n AUG 11 2013 donticsortho Member Since: 06/25/12 Post: 3 of 48 Fesdds, do you set your appointments like this? 1. Seps 2. Fit bands 3. Sep 4. Cement Each appointment a week apart? I am thinking about combining two and three so they make three visits instead of four. However, I’m not sure if the seps will stay in. I’m slowly realizing I’m not a huge fan of the bonded expanders. n AUG 11 2013 14 OCTOBER 2013 // orthotown.com http://www.orthotown.com http://www.Orthotown.com http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown October 2013

Wired for Success: New Patient Workflow in the Digital “Paperless” Office
Orthotown.com Highlights
Lean and Mean Ortho: Cost-saving Measures in an Orthodontic Practice
Phase I Expansion/Retention
Corporate Profile: Ortho Organizers
New Products
Continuing Education: Treatment by Twelves
A Common Sense Approach to Six Percent
Overhead – Friend or Foe?
Ad Index
In Memoriam: Tribute to Dr. Craig Andreiko

Orthotown October 2013